MEDICARE: SHARI A ROSEN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	162431	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QP3351	OTHER	NY	EMPIRE BCBS

General Provider Information

NPI Number	:	1770535379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI A ROSEN PT

Provider Business Mailing Address
First Line	:	435 E 77TH ST
Second Line	:	APT 4A
City	:	NEW YORK
State	:	NY
Zip	:	10021
Country	:	US
Telephone Number	:	212-988-6914
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E 74TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-3912
Country	:	US
Telephone Number	:	212-452-2400
Fax Number	:	212-452-2411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	02/09/2009

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Directions to “ SHARI A ROSEN PT” Practice Location

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